Chapter 43. Objectives. Objectives 01/09/2013. Hazardous Materials

Transcription

1 Chapter 43 Hazardous Materials Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved. Objectives 1. Define key terms introduced in this chapter (slides 11-13, 37-38). 2. Explain the U.S. Department of Transportation placard system and the National Fire Protection Association symbols for identifying hazardous materials (slides 14-16). 3. Explain the purpose of shipping papers and material safety data sheets (slide 17). 4. List sensory indications that a hazardous materials situation may exist (slides 18-19). 5. Identify resources that can be used in the identification and management of hazardous materials incidents (slides 20-22). Objectives 6. Differentiate between the levels of hazardous materials training identified by the Occupational Safety and Health Administration (slides 23-24). 7. Explain the general rules of hazardous materials rescue (slides 25-28). 8. Discuss the components of hazardous materials incident management, including (slides 29-36): a. Preincident planning b. Considerations in implementing the plan c. Establishing safety zones d. Emergency procedures, including decontamination, that should take place in each zone 1

2 Objectives 9. Describe special considerations in responding to and managing patients exposed to or contaminated with radiation (slides 39-45). 10. Differentiate between radiation sickness, radiation injury, and radiation poisoning (slides 46-47). 11. List factors that determine the amount of risk posed to patients and rescuers by a source of radiation (slides 48-49). 12. Describe the importance of being knowledgeable about terrorist attacks involving weapons of mass destruction (slides 50-51). Topics Identifying Hazardous Materials Guidelines for Hazardous Materials Rescues CASE STUDY Dispatch 2

3 EMS Unit 101 Proceed to the intersection of Route 46 West and Baldwin Road you have a collision involving a truck and passenger vehicle. No patient information is available. Time out 2337 Upon Arrival You spot police rerouting traffic; they ve cordoned off the scene Way up ahead on the shoulder of the highway you can just see a passenger vehicle in front of a large tanker truck How would you proceed with the assessment of this patient? 3

4 Identifying Hazardous Materials Back to Topics What Is a Hazardous Material? Poses a threat or unreasonable risk to life, health, or property Principle dangers are toxicity, flammability, and reactivity ( Jeff Forster) 4

5 TRACEM Thermal Radiological Asphyxiation Chemical Etiological Mechanical ( Jeff Forster) Placards and Shipping Papers Placards Four-digit UN number identifies specific chemical Color identifies class of hazard 5

6 Fire Health Reactivity NFPA 704 System Shipping papers must be transported with hazardous material Material safety data sheets contain information on hazardous material Using Your Senses 6

7 Smoking Extraordinary fire conditions Boiling or spattering materials that were not heated Wavy or unusually colored vapors Frost near a container leak Unusual condition of containers Resources Resources North American Emergency Response Guidebook CHEMTREC Chemtel, Inc. 7

8 Information to Provide Your name, callback number, and fax number Nature and location of product UN identification number Shipping paper information Type of container and size Quantity of material Local weather conditions Number of injuries and/or exposures Emergency services involved Training Required by Law Levels of Training First Responder Awareness First Responder Operations Hazardous Materials Technician Hazardous Materials Specialist 8

9 Guidelines for Hazardous Materials Rescues Back to Topics General Rules Protect the safety of all rescuers and victims Provide patient care Decontaminate clothing, equipment, and the vehicle 9

10 RAIN Recognize Avoid Isolate Notify Cordon off area Evacuate bystanders Awareness level about whether to enter scene Incident Management Preincident Planning Plan Should Include: One command officer Clear chain of command System of communications Predesignated receiving facilities 10

11 Incident Management Implementing the Plan Information Needed Nature of the problem Identification of hazardous material The type and condition of containers Existing weather conditions Whether or not fire is present Time elapsed What has been done so far Number of patients Danger of victimizing more people Incident Management Establishing Safety Zones 11

12 Incident Management Emergency Procedures Emergency Procedures Initial (gross) decontamination occurs at entrance to warm zone Perform primary assessment in warm zone Wear special equipment in warm zone Remove protective equipment before entering cold zone Protect your equipment during transport In case of exposure, decontaminate yourself All rescuers should be examined afterwards Thoroughly decontaminate vehicle 12

13 Radiation Emergencies Exposure and Contamination Exposure and Contamination Exposure occurs without material touching the body Contamination occurs when radioactive material contacts patient Patient may be exposed, contaminated, or both Radiation Emergencies Guidelines for Radiation Emergencies 13

14 Wait for a Radiation Safety Officer If unavailable, place patient in body bag up to neck, cover hair, and wipe face, bringing wipes with you in a bag Time is a critical factor Radiation Emergencies Procedures for Radiation Emergencies Scene Safety Look for radiation symbols on approach Park upwind If trained to do so, wear full protective gear that leaves no hair or skin exposed 14

15 Personal Protection Time Distance Shielding Quantity Patient Care and Personal Decontamination Focus on life threats, not radiation Manage injuries as you normally would Decontaminate yourself immediately after providing patient care Vehicle/Equipment Decontamination Check anything involved for contamination Thoroughly decontaminate vehicle inside and out May need to dispose of equipment 15

16 Radiation Emergencies Problems Caused by Radiation Radiation sickness Radiation injury Radiation poisoning Radiation Emergencies Protection from Radiation 16

17 Factors Affecting Exposure Amount and type of shielding Strength of radiation source Distance from source Type of radiation Length of exposure Extent of body exposure Terrorist Attacks Involving Weapons of Mass Destruction Common Chemicals Class 2 poisonous gas Class 6 irritants or poisons Class 7 radioactive 17

18 CASE STUDY Follow-Up CASE STUDY Scene Size-Up Passenger vehicle versus tanker truck Park uphill and upwind Utilize Emergency Response Guidebook Flammable Liquid placard You spot a small leak and vapors Report given to incident commander CASE STUDY Primary Assessment Two patients, a male and female in their forties Decontaminated by fire personnel Vital signs are within acceptable limits Place patients on oxygen via nonrebreather masks 18

19 CASE STUDY Primary Assessment Conclude neither patient is high priority Perform secondary assessment on scene CASE STUDY Secondary Assessment Neither appears injured Take spine precautions using spine board Patients only report dizziness Cover stretchers with thick plastic Load patients into two ambulances for transport CASE STUDY Treatment and Reassessment Perform reassessment every 15 minutes No changes en route Transfer care to ED Decontaminate yourself and ambulance immediately afterward 19

20 Critical Thinking Scenario Dispatched to a local factory; an employee has collapsed in a storage area Upon arrival, the foreman tells you the storage area contains a large number of hazardous chemicals A leaking chemical container was found in the storage area He s not sure if the patient was exposed to the chemical or collapsed for other reasons Critical Thinking Scenario You peek around the corner and see that the patient is not moving He s lying in a prone position No odors or vapors are noted in the area Critical Thinking Questions 1. What would be your first action? 2. How would you manage the scene? 3. Would you call for any additional resources? If so, who? 4. When would you begin your emergency care for the patient? 20

21 Reinforce and Review Please visit and follow the mybradykit links to access content for the text. 21